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V007: USE OF ADVANCED INTRAOPERATIVE NAVIGATION FOR PERCUTANEOUS TRANSORBITAL INFERIOR OPHTHALMIC VEIN ACCESS IN EMBOLIZATION OF A RESIDUAL TYPE D CAROTID-CAVERNOUS FISTULA
Osman Baig¹; Sarah J Snyder, BS²; Nathan S Yu¹; Luis O Tierradentro-Garcia, MD¹; Madhura Tamhankar, MD¹; Redi Rahmani, MD³; Linda Bagley, MD¹; Omar A Choudhri, MD¹; ¹University of Pennsylvania; ²Lewis Katz School of Medicine at Temple University; ³University of Louisville

This video presents a rare case of image-guided percutaneous embolization of a residual Barrow type D carotid-cavernous fistula via the inferior ophthalmic vein. After conventional transvenous treatment failed, direct transorbital access was achieved using Brainlab AngioFusion for trajectory planning and Siemens Needle Guidance for real-time alignment. The procedure resulted in symptom resolution and restored vision, highlighting the critical role of intraoperative navigation tools in treating anatomically challenging CCFs.

 

 

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